Hello and welcome to Making Sense of Women's Health. I am Roberta Bass, and I am a women's health physiotherapist, a Pilates instructor, menopause mentor, remedial hypnotist, and founder of Thrive and Shine Women's Wellness Limited.

Today, we are going to talk about joint pain and other musculoskeletal problems that are common during peri- and post-menopause. So, if you are a woman in your mid-40s to mid-50s and experience discomfort or stiffness, you are not alone.

This is a common issue I see with many of my female Pilates clients in this age group, and it can greatly impact daily life and overall well-being. Over the years, as a physiotherapist, I have treated many women with conditions like greater trochanter pain syndrome (GTPS), which we were always taught as physios was quite common in women in their 40s and 50s.

However, it wasn't until I specialised in women's health that I truly understood why it was common at this time and its connection with menopause. Even then, while I was working in the NHS, I wasn't allowed to address the menopause side of it. Even though it was the underlying cause, we had to treat the specific problem they came in with.

Now that I work independently, I'm able to take a holistic approach, which I love, and this allows me to prioritise managing menopause itself or any other underlying condition, which is just as important, if not more so, than providing those specific physiotherapy exercises we used to give out. This comprehensive approach means I can offer support tailored to each woman's unique needs, something I wasn't able to do in my previous employment, shall we say.

Today, we are going to explore:

• Why you might be experiencing joint and muscle pain.
• Common conditions linked to menopause.
• Strategies to help you manage and improve these issues.

Why Joint Pain and Musculoskeletal Issues Happen During Menopause

Joint pain and musculoskeletal issues can be particularly troublesome during peri- and post-menopause. There are many reasons for this. One of the key factors is hormonal changes. As we know, hormones wreak havoc on many aspects of the body.

• Oestrogen: This hormone is essential for maintaining joint and connective tissue health due to its anti-inflammatory properties. As oestrogen levels drop during menopause, the body's ability to manage inflammation also decreases, which can lead to increased joint pain and muscle discomfort.
• Collagen: Oestrogen also stimulates collagen production, which is crucial for the flexibility and strength of joints, tendons, and muscles. Reduced oestrogen results in less collagen, which causes tissues to become stiffer and less elastic. This can lead to pain and injuries in tendons, muscles, and other connective fibres.

Another issue is poor sleep, which is common during perimenopause. This might be due to hot flushes, night sweats, anxiety, or general hormonal changes. Lower progesterone levels, which have a calming, sleep-promoting effect, make it harder to get restful sleep. Without adequate sleep:

• Pain tolerance decreases.
• Pain in joints and muscles feels more intense.
• The body struggles to repair and recover tissues, causing more stiffness and inflammation.

Additionally, natural ageing slows tissue repair, leading to more wear and tear on joints. Combine this with reduced hormonal support, and joint pain becomes even more pronounced. Weight gain, which often accompanies menopause, adds pressure to weight-bearing joints like the hips, knees, and lower back, exacerbating joint problems and muscle strains.

Common Conditions Related to Menopause

Several common conditions may be linked to peri- and post-menopause. Let’s go through some of them:

• Osteoarthritis (OA): This wear-and-tear condition affects cartilage, leading to joint pain, swelling, stiffness, and sometimes crepitus (the crackling sound when moving joints). It is more common in weight-bearing joints like the knees and hips but can also occur in the hands and spine. Menopause accelerates cartilage breakdown due to reduced oestrogen.
• Muscle Pain and Stiffness: Generalised aches and pains, especially after periods of inactivity or in the morning, are common. These occur due to stiffness caused by hormonal changes and can worsen with poor sleep.
• Tendinopathies: Tendon conditions, such as:
   
  • Rotator cuff issues (shoulder).
•  
  • Achilles tendinopathy (heel).
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  • GTPS (pain on the outside of the hip).
    These conditions cause pain, stiffness, and limited range of motion, often aggravated by specific activities or positions.
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• Plantar Fasciitis: Inflammation of the connective tissue at the base of the foot, often causing pain during the first steps after resting. It’s linked to reduced connective tissue elasticity, weight gain, and changes in foot biomechanics.

Strategies for Managing Joint Pain

Now let’s explore how you can improve joint and musculoskeletal pain using the SENSSE™ Method:

1. Subconscious:
   Your mindset plays a crucial role in managing pain. Chronic stress and anxiety can amplify pain perception. Build resilience with:
    
   • Journaling.
2.  
   • Positive self-talk.
3.  
   • Relaxation techniques.
4.  
5. Empowerment:
   Educate yourself about menopause and how it impacts your joints and muscles. Advocate for your needs and set SMART goals to make sustainable changes.
6. Nutrition:
    
   • Focus on anti-inflammatory foods: omega-3s, leafy greens, and berries.
7.  
   • Reduce processed foods, sugar, and trans fats to decrease inflammation.
8.  
   • Stay hydrated to support joint lubrication and reduce stiffness.
9.  
10. Stress Management:
     
    • Incorporate daily mindfulness or relaxation practices.
11.  
    • Try progressive muscle relaxation to calm your nervous system and reduce pain sensitivity.
12.  
13. Sleep:
     
    • Prioritise quality sleep for tissue repair and inflammation reduction.
14.  
    • Practice good sleep hygiene, such as reducing screen time before bed and maintaining a consistent sleep schedule.
15.  
16. Exercise:
     
    • Start with low-impact activities like walking or swimming.
17.  
    • Incorporate strength training to support joint stability and stretching for flexibility.
18.  
    • If needed, consult a physiotherapist for tailored exercises.
19.  

Final Thoughts

Managing joint pain and musculoskeletal issues during menopause can be challenging, but with the right strategies, it’s absolutely possible to feel better. By addressing hormonal and lifestyle factors holistically, you can take meaningful steps towards improved well-being.

If you’d like support, I offer both online and in-person appointments at my clinic in North Somerset. Together, we can create a personalised plan to help you feel your best.

Thank you for joining me on Making Sense of Women's Health. Until next time, take care and continue to prioritise your health and well-being.